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General NPI Number Information
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NPI Number | 1881709533
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Entity Type | Organization
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Legal Business Name | HENKE FAMILY CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7977 STEUBENVILLE PIKE
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City | OAKDALE
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State | PA
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Zip | 15071-9378
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Country | US
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Telephone | 724-695-9120
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Fax |
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Provider Business Mailing Address
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Address Line | 7977 STEUBENVILLE PIKE
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City | OAKDALE
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State | PA
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Zip | 15071-9378
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Country | US
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Telephone | 724-695-9120
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KELLY J HENKE
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Credential | D.C.
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Telephone | 724-695-9120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 763
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License Number State | WV
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